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Revenue Cycle Management Software

What Is Revenue Cycle Management Software?

Revenue cycle management software is designed to assist healthcare providers in managing their revenue cycle effectively. One of the key features of these systems is to automate a wide range of tasks that are often performed by human staff.

Automating critical aspects of the revenue cycle, including the medical billing program, like claims processing, remit posting, denial management and reporting, speeds up the process of being paid for social and medical services. This significantly improves efficiency by eliminating any manual data entry. However, not all revenue cycle management (RCM) platforms are made equal. The best software needs to have a set of features that meets all essential management requirements of healthcare organizations to set it apart from its competition.

 

Perhaps the most vital of these RCM features is the ability to automate and streamline the workflow of claim submission, processing of patient payments, keeping track of rejections or denials, and being able to improve billing and financial department efficiency throughout the lifecycle of a claim and the entire revenue cycle of patient care.

Pre-billing eligibility checks, claims scrubbing, integrating with the EMR (Electronic Medical Records) or EVV solutions you have in place, generating 837s, and automatic positing of 835s with the simple click of a button are all critical features that the right healthcare revenue cycle management software provides. Having the capacity to automate these revenue cycle tasks can significantly reduce the need for manual intervention which is especially important in an industry that is plagued by staffing shortages.

When a healthcare practice can automate repetitive activities, including those that are part of the revenue cycle, they will have more time to focus on their main goal, which is to provide quality patient care. Healthcare staff does not want to be bogged down with inefficient medical billing software that cuts hours out of their normal day-to-day responsibilities and becomes a burden on management.

Another important aspect that the ideal RCM system has is its ability to adapt to changing reimbursement and medical billing requirements. Given how regulations in healthcare are constantly evolving, it is crucial for healthcare providers to make sure that their chosen solutions can accommodate these changes seamlessly.

The choice of revenue cycle management software for medical practices is a major decision and selecting a product for the right price that has all the features and functionality a finance or billing team needs, as well as features senior management needs, is crucial. An agency needs to select an RCM system that is flexible and able to meet their unique requirements, while fitting into their workflow.

That is why health care providers need to really do their due diligence and select a healthcare revenue cycle management solution that fits their every need.

A Revenue Cycle Management Software for you and your patients 

Features To Expect from Revenue Cycle Management Software

There are many advantages that good revenue cycle management platforms can provide to a healthcare organization. The most important of these capabilities include billing automation and tracking of a claim throughout its entire lifecycle, from submission to payment collection to exporting subledger information. Additionally, good revenue cycle management software also allows for more transparent communication between different departments. For instance, with Millin, our issue tracker immediately catches patient demographic or service data inconsistencies which can be communicated back to staff for correction.

Here are the most essential features you should look for when deciding on the right practice management solution to help improve your agency's revenue cycle. With Millin, all of these features are included in the price of the subscription fee:

  • Integration with existing electronic health records that allow the automatic importing of patient records into the billing system, helping providers save...
Read More

Here are the most essential features you should look for when deciding on the right practice management solution to help improve your agency's revenue cycle. With Millin, all of these features are included in the price of the subscription fee:

  • Integration with existing electronic health records that allow the automatic importing of patient records into the billing system, helping providers save time while minimizing errors
  • Automatically flag claims submissions in cases of billing issues, so they can be edited prior to submission, leading to a decrease in denials and an increased percentage of claims reimbursement
  • Automatically checks eligibility for insurance coverage to quickly confirm allowed services for insured patients without the need to check coverage manually
  • Intuitive dashboards that provide billers and management immediate access to essential billing data, so healthcare providers can make business decisions effectively
  • Enhanced management of eligibility that ensures only patients who are allowed will receive the necessary services, ensuring proper reimbursement
  • Improved workflow for all claims that allows for claims to be processed efficiently and accurately while reducing denials
  • Comprehensive health system with reporting that allows for fully detailed, filterable reports on any claim, service, individual, or location information that resides in the system
  • Correctly identifying inaccurate billing codes automatically to allow medical practices to make changes to claims before submission or resubmission
  • Automatically applying accurate coding and modifying coding errors to all services that require one to ensure the provider is reimbursed at the correct rate for all services
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womanOffice
womanOffice

Here are the most essential features you should look for when deciding on the right practice management solution to help improve your agency's revenue cycle. With Millin, all of these features are included in the price of the subscription fee:

  • Integration with existing electronic health records that allow the automatic importing of patient records into the billing system, helping providers save...
Read More

Here are the most essential features you should look for when deciding on the right practice management solution to help improve your agency's revenue cycle. With Millin, all of these features are included in the price of the subscription fee:

  • Integration with existing electronic health records that allow the automatic importing of patient records into the billing system, helping providers save time while minimizing errors
  • Automatically flag claims submissions in cases of billing issues, so they can be edited prior to submission, leading to a decrease in denials and an increased percentage of claims reimbursement
  • Automatically checks eligibility for insurance coverage to quickly confirm allowed services for insured patients without the need to check coverage manually
  • Intuitive dashboards that provide billers and management immediate access to essential billing data, so healthcare providers can make business decisions effectively
  • Enhanced management of eligibility that ensures only patients who are allowed will receive the necessary services, ensuring proper reimbursement
  • Improved workflow for all claims that allows for claims to be processed efficiently and accurately while reducing denials
  • Comprehensive health system with reporting that allows for fully detailed, filterable reports on any claim, service, individual, or location information that resides in the system
  • Correctly identifying inaccurate billing codes automatically to allow medical practices to make changes to claims before submission or resubmission
  • Automatically applying accurate coding and modifying coding errors to all services that require one to ensure the provider is reimbursed at the correct rate for all services
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Benefits of Leveraging the Right Revenue Cycle Management Software

The following are the most noteworthy benefits providers can get with the right healthcare revenue cycle management system that they can't always get with their EHR solution:

 

Improvement in Getting Claims Paid

A robust revenue cycle management platform prioritizes completing all front-end tasks with accurate billing to make sure that claims for billable charges get paid the first time. Such medical billing activities include the collection of correct patient details, insurance verification, and applying the appropriate medical codes and modifiers to ensure full payment and revenue generation.

When claims are accepted immediately, healthcare providers can significantly reduce the time spent on the billing process and the whole patient service revenue cycle. You no longer need to spend time correcting issues that will cause a claim to be rejected in the first place. Because the claim goes out correctly the first time you can limit denials and subsequently the time spent on the phone managing those denials. Ensuring all information on every claim is precise through an eligibility check or pre-billing scrubbing feature is absolutely crucial for claims management in any revenue cycle. This is a practice that is left out of a lot of EHR solutions.

Increased Overall Collections and Revenue

Healthcare facilities, especially those designated as non-for-profits, need to make sure that every dollar is accounted for. Leaving money on the table due to incorrectly submitted or underpaid claims is simply not an option. Your RCM system needs to adhere to these high standards, leaving no room for error in your claims management process and revenue cycle workflow.

When a claim at your practice is denied, underpaid, or sent out incorrectly, the provider will not receive the payment that is due to them. This makes it exceptionally difficult to handle ongoing facility costs. Decision makers need to evaluate the full ROI for each of the different revenue cycle management solutions they're considering and select the vendor or software that prioritizes getting correctly reimbursed for every service and claim. This will maximize revenue from unpaid claims and patient collections to increase cashflow. MillinPro routinely generates returns 10x the price of the system.

With the right medical billing service, along with best RCM practices. facilities can reduce claim denials by uncovering the patterns that lead to them. Having the ability to recognize these issues and resolve them before they take place can allow providers to avoid claim denials as much as possible.

This ensures that the healthcare facility receives their reimbursements in a timely manner, so they can manage their revenue cycle and expenses better.

More Focused on Providing Quality Care

A medical practice that can apply revenue cycle management effectively can significantly reduce the time and money they spend correcting mistakes and trying to appeal claims. This lets them spend more time focusing on the quality of service that they provide to their patients and less time on revenue cycle management.

When they receive quality care consistently, patient satisfaction with the services provided will increase and they are more likely to value their healthcare providers. Clinics and medical practices that grow consistently year over year are able to do so because they are prioritizing services, rather than chasing money for denied claims that should have been avoided if proper RCM tactics were employed the first time around.

Healthcare facilities expertise lies in the hands of those providing services and that's why selecting a proper EHR is important. However, when it comes to billing and reimbursement let the revenue cycle experts handle your healthcare revenue cycle.

Enhanced Patient Experience

Because a good RCM software offers fully transparent glimpses into demographic and payer-level information and issues, administrative staff at a given provider can effectively communicate with those receiving services and alert them accordingly when there is an issue in the revenue cycle. A good practice management solution should be able to track unit utilization which will dictate the types of services an individual is eligible for and when they can receive those services, all of which affect reimbursement.

Part of a strong revenue cycle is knowing if and when an individual is eligible or ineligible for a given service can allow a patient to get the most of his or her time spent at the provider and work with staff on a treatment plan that reflects the best use of time for a visit to the practice.

Reduced Burden for Admin Staff

Finally, healthcare office staff will experience reduced burdens when managing administrative tasks with the use of quality RCM software and good revenue cycle management. This is possible because these systems streamline repetitive administration activities, so employees can operate more efficiently, thus increasing revenue.

The right platform also ensures all admin tasks are performed accurately to minimize denials. With a higher probability of claims being processed in a short period, staff members do not need to spend a significant amount of time analyzing and appealing denials, which is a testament to a proper revenue cycle.

Most good RCM systems can cut the workload and time of 4-5 team members by about a third which significantly reduces the price of labor on your agency. By automating certain parts of the workflow, a good revenue cycle management software platform can save administrative departments hours and hours of work each week. There's also less of a probability of staff needing to get involved in an area that isn't their day-to-day core competency. They can stay focused on what's important for them, increasing efficiency and revenue.

Why Choose Our Revenue Cycle Management Software

MillinPro is a leading healthcare revenue cycle management software designed by experts in the field. It offers a complete solution to provide agencies with the financial insight they need to succeed.
 
Our cloud-based solution combines in-depth expertise as well as complex technology designed to maximize a healthcare provider's financial performance. Furthermore, we have a team of dedicated industry specialists whose history is in claims management, that will work with your facility to create a flourishing partnership.
 
MillinPro started out as a cloud-based system that we used internally to apply the best practices to streamline medical billing workflows. Due to the rising demand for quality practice management solutions, we have decided to license our effective revenue cycle management system to health and human service agencies looking for a robust platform that they can integrate with their EHR.
 
We leverage a comprehensive rule-based engine that is constantly being updated according to changes in state and payer rules and regulations. This ensures that healthcare organizations can stay on top of their reimbursement from patients and insurance companies and maximize their revenue while making sure that they stay compliant.
whyMillin-1

When you choose MillinPro, you can benefit from the following:

  • Millin incorporates many of the rules into its rules engine thus removing human error
  • Pre-billing scrubbing features
  • Proprietary issue tracker to easily document and track claims issues
  • With the Clearinghouse and eMedNY (electronic New York State Medicaid system) web-services integration, you no longer need to leave the system to...
Read More

When you choose MillinPro, you can benefit from the following:

  • Millin incorporates many of the rules into its rules engine thus removing human error
  • Pre-billing scrubbing features
  • Proprietary issue tracker to easily document and track claims issues
  • With the Clearinghouse and eMedNY (electronic New York State Medicaid system) web-services integration, you no longer need to leave the system to submit claims or download remittances
  • Customizable dashboard
  • Incorporated APG calculator for services that require one (all non-APG payers are submitted at the contracted rate)
  • Batch Insurance Eligibility verification.
  • Comprehensive reporting system.
  • Secure HIPAA (Health Insurance Portability and Accountability) compliant web-based system back-ups on the West-Coast.
  • Ability to integrate with EMR (Electronic Medical Records) systems via HL7, API, or data upload.
  • Ability to integrate with your accounting system.
Read Less
whyMillin-1

When you choose MillinPro, you can benefit from the following:

  • Millin incorporates many of the rules into its rules engine thus removing human error
  • Pre-billing scrubbing features
  • Proprietary issue tracker to easily document and track claims issues
  • With the Clearinghouse and eMedNY (electronic New York State Medicaid system) web-services integration, you no longer need to leave the system to...
Read More

When you choose MillinPro, you can benefit from the following:

  • Millin incorporates many of the rules into its rules engine thus removing human error
  • Pre-billing scrubbing features
  • Proprietary issue tracker to easily document and track claims issues
  • With the Clearinghouse and eMedNY (electronic New York State Medicaid system) web-services integration, you no longer need to leave the system to submit claims or download remittances
  • Customizable dashboard
  • Incorporated APG calculator for services that require one (all non-APG payers are submitted at the contracted rate)
  • Batch Insurance Eligibility verification.
  • Comprehensive reporting system.
  • Secure HIPAA (Health Insurance Portability and Accountability) compliant web-based system back-ups on the West-Coast.
  • Ability to integrate with EMR (Electronic Medical Records) systems via HL7, API, or data upload.
  • Ability to integrate with your accounting system.
Read Less

Bottom line

With more than 40 years of experience in health and human services billing and revenue cycle management processes, we can guide you in improving your efficiencies and revenue while minimizing claim denials as much as possible. Let us help you make a difference to your bottom line by allowing you to automate revenue cycle management tasks while you focus on essential services to your patients.

Contact our team to schedule a demo today.

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With over 40 years of Health & Human Services billing experience and expertise, we can help increase efficiencies and reduce or even eliminate denials. Experience Revenue Cycle Management Software & Services from the Company You Trust. 

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